While most home health care providers have shifted priorities in 2020 due to the COVID-19 pandemic, one item that is not shifting for most agencies that deliver Medicaid services is the January 2021 implementation requirements for Electronic Visit Verification, or EVV.
Originally set to launch Jan. 1, 2020, EVV implementation has, in effect, been delayed by a year as nearly all states applied for and received an extension to Jan. 1, 2021. Many states used that extension to work on implementation details, so now in what will be a busy and hectic back-half of the year, agencies must begin preparing staff to avoid change management woes as January approaches.
The majority of states operate in what’s called an open model for EVV, which grants agencies leeway to choose a technology solution. Agencies should take advantage of this freedom to consider the advantages of alternative options for compliance relative to the state-procured system. An alternate system that automates processes, works with an agency’s existing software and operations and minimizes unnecessary changes to workflow will support a smooth rollout and streamline operations.
Here is a look at how agencies must prepare both administrative staff and caregivers as they move EVV forward.
Start early to take advantage of state transition periods
Many states are allowing for a transition period during which agencies are expected to have implemented EVV, but claims will not be denied. Agencies can use this time to test workflows and monitor EVV adoption — most importantly, ensuring that employees are properly equipped to meet the new mandate.
Industry best practice is to use this “soft launch” process as a grace period for agencies to implement EVV successfully without penalty to payment, says CellTrak EVV expert Courtney Martin.
The transition period can provide an opportunity to use the EVV system in a way that gives all involved — both administrators and caregivers — time to adjust to the new workflow. Agencies must plan for this process of change management, understanding that they are going to need a couple of months to monitor progress, change habits and reinforce training.
Avoid claims denials with a well-planned workflow
Each state has specific requirements for EVV data, both in terms of what data is collected and in what format that data is shared with the state. In order to comply with unique state mandates for each state in which they operate, agencies must thoughtfully plan a workflow that supports compliance, and then execute – considering systems that are already in place.
Compliance begins with identifying the best EVV solution to support the agency, setting up the right workflow and then training staff accordingly.
Administrators are tasked with the back-office functions that support compliance — such as adjusting schedules, overseeing staffing and managing alerts — as well as billing and payroll. At the highest level, administrators are typically responsible for measuring progress and mitigating the risk of claims denial — so their workflow can be impacted most noticeably by compliance efforts.
During a soft launch, EVV data is submitted and claims are paid regardless of whether the data is perfect. The exceptions are flagged for an administrator who can identify systemic or repetitive issues and correct them before claims denial goes into place. This opportunity to essentially test internal processes without denied claims can be the factor that leads to a smooth transition come January 1.
Make technology easy for caregivers
Caregivers have a lot on their plate, and EVV is designed to make their jobs easier, both in terms of simplifying visit documentation and supporting safety during each visit. EVV presents the opportunity to reduce the administrative burden on caregivers and enable them to focus on providing care. Proactively managing the transition to using EVV is key to success.
That means it is the responsibility of agency leaders to not only train caregivers on the technology, but to allow time for a smooth adoption — potentially one to two months just for caregivers to adjust to the routine of electronically checking in and out of visits.
“Caregivers need to know the workflow for the visit,” Martin says. “Some agencies operate with a lot of scheduled visits, so the caregiver needs to know how to find their schedule and check in and out. But if the caregiver is going on a visit that is unscheduled, then the caregiver needs to know how to manage that in the tool as well.”
All of that comes down to a matter of training, she says, and using checklists to both monitor progress and manage expectations. And just as caregivers need to optimize their use of the EVV tool, providers must optimize their training process, since the amount of turnover in the workforce means that ongoing training needs to be part of the natural cadence of the agency’s operations.
“Plan for a soft launch and a learning period rather than expecting overnight compliance,” Martin says. “Give both your administrative staff and caregivers time to adjust to the new requirements. Planning for this change proactively will help agencies be EVV compliant, but will also improve efficiency and enable the caregiver in real time to provide the best care possible.”
To learn more about how CellTrak can help you navigate EVV in 2020 and beyond, visit CellTrak’s EVV state map to understand what is happening in your state — and stay tuned for more on EVV at HHCN from CellTrak.